Patients will be allocated to receive either standard treatment, hypofractionated treatment
or APBI.

Radiation therapy should be started between 4 and 12 weeks after the last surgery.

Patients treated with standard whole breast irradiation will receive a total dose of 50 Gy
in 25 fractions, 2 Gy per day, 5 days a week. The boost of 16 Gy will be delivered in 8
fractions for all patients after completion of the 50 Gy, without interruption. All patients
will receive one fraction per day, 5 fractions a week.

Patients treated with hypofractionated irradiation will receive a total dose of either 40 Gy
(in 15 fractions, 2.66 Gy per day) or 42.5 Gy (in 16 fractions, 2.65 Gy per day)5 days a
week.

Patients treated with APBI will receive a total dose of 40 Gy in 10 fractions, delivered
twice a day over a time period of 5-7 days. Each daily dose must be separated by 6 hours.

Patients will be followed at 3 and 6 month after the last dose of irradiation, at 12 months
after the date of last surgery and then on a yearly basis during 10 years.

- Radiotherapy should be started more than 4 weeks and less than 12 weeks after last
surgery

- Surgical clips (4 to 5 clips in the tumor bed)

- No prior breast or mediastinal radiotherapy

- ECOG 0-1

- Information to the patient and signed informed consent

Exclusion Criteria:

- Multifocal invasive ductal carcinoma defined as the presence of at least two distinct
tumors that are separated by normal tissue or when the distance between the two
lesions does not permit conservative surgery

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